GESTATIONAL TROPHOBLASTIC DISEASES: FOURTEEN YEAR EXPERIENCE OF OUR CLINIC

Objective: To evaluate the patients followed and treated with a diagnosis of gestational trophoblastic disease in our clinic retrospectively. Design: The files of the patients followed and treated in our clinic between 1996 and 2010 with a diagnosis of gestational trophoblastic disease were examined. Setting: Yuzuncu YIl University, Faculty of Medicine, Department of Obstetrics and Gynecology, Van. Patients: The 147 patients with satisfactory information in their files within 173 patients treated and followed in our clinic between 1996 and 2010 with a diagnosis of gestational trophoblastic disease. Interventions: No intervention to the patients. Main outcome measures: Demographic and obstetric parameters, blood group,obstetric history in the previous pregnancy, contraceptive method, gestational week and complaints on admission, hystological type, stage, treatment and complications of gestational trophoblastic disease and presence of associated clinical problems. Results: In our clinic, 18.324 deliveries occured and 173 cases had a diagnosis of gestational trophoblastic disease between 1996 and 2010. Out of 147 patients, 72 (49%), 61 (41.5%), 3 (2%), 7 (4.8%) and 1 (0.7%) had diagnoses of complete mole, partial mole, invasive mole, choriocarcinoma and placental site trophoblastic tumor, respectively. In 3 patients (2%), subtype could not be determined. Mean age was 31.45 ± 10.29 years and the most common complaint was vaginal bleeding (77.6%). As the primary therapy, suction curettage with oxytocin infusion or hysterectomy was appplied to 140 and 7 patients, respectively. A single agent chemotherapy was performed to 26 patients while a multiagent chemotherapy was given to 6 patients. All patients were followed up by serial serum ßhCG measurements. Conclusions: The incidence of gestational trophoblastic disease in our clinic was calculated as 8.1 per 1000 deliveries and socio-economic and educational status of majority of the patients were low. Lowering the high birth rate in our region may contribute to decrease of disease incidence.

[1]  K. Curtis,et al.  Combined oral contraceptive and intrauterine device use among women with gestational trophoblastic disease. , 2009, Contraception.

[2]  J. Lurain Pharmacotherapy of gestational trophoblastic disease , 2003, Expert opinion on pharmacotherapy.

[3]  N. Tanaka,et al.  Changes in the incidence of molar pregnancies. A population-based study in Chiba Prefecture and Japan between 1974 and 2000. , 2003, Human reproduction.

[4]  E. Newlands,et al.  Chemotherapy for trophoblastic disease: current standards , 2002, Current opinion in obstetrics & gynecology.

[5]  P. Disaia GESTATIONAL TROPHOBLASTIC NEOPLASIA , 2002 .

[6]  S. Ozalp,et al.  Hydatidiform mole in Turkey from 1932 to 2000 , 2001, International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics.

[7]  S. Shapiro,et al.  Oral contraceptive use and risk of gestational trophoblastic tumors. , 1999, Journal of the National Cancer Institute.

[8]  T Gül,et al.  A review of trophoblastic diseases at the medical school of Dicle University. , 1997, European journal of obstetrics, gynecology, and reproductive biology.

[9]  R. Berkowitz,et al.  Management of complete molar pregnancy. , 1987, The Journal of reproductive medicine.

[10]  M. Bracken,et al.  Epidemiology of hydatidiform mole and choriocarcinoma. , 1984, Epidemiologic reviews.

[11]  M. Bracken,et al.  Hydatidiform mole in the United States (1970-1977): a statistical and theoretical analysis. , 1982, American journal of epidemiology.